‘Commission bias’ is the term used to describe the human tendency to do things rather than not do things. Faced with a problem, we have an innate desire to act, to intervene, to actively do something, even if our actions might be ineffective or even make the situation worse. Despite the risks, we prefer action to inaction, even if the outcome of our actions is uncertain or harmful. This universal tendency to act lies at the root of many human problems. Sometimes, it would be far better if we just sat back, reflected and chose our actions with greater care. In the words of the Buddhist proverb: ‘Don’t just do something; sit there’.
Against this background, this extract from my new book, ‘Coping with Coronavirus,’ looks at doing what we can to assist with our psychological response to coronavirus. In addition to following public health advice to minimise risk and reduce virus transmission, I emphasise the importance of doing things that are not related to coronavirus but help maintain general health (e.g. exercise), consciously practicing compassion for ourselves and others, and rewarding ourselves for our achievements, which is especially important during times of ubiquitous anxiety.
Do other things (eat, sleep, exercise, go outside if you can)
It is easy to become obsessed by coronavirus and the blanket media coverage that it commands. It is also easy to become downhearted by the effect of coronavirus on the world, the loneliness of ‘social distancing’ and the uncertainties of our new situation, along with personal illnesses, losses or bereavements. In these circumstances, it is more important than ever that we prioritise our physical and mental wellbeing in order to both minimise the effect of coronavirus on us and maintain our mental health.
Both physical and mental wellbeing matter. We are embodied creatures: our heads are firmly connected to our bodies, so there is no real distinction between physical and mental health. In our present circumstance, we need to pay particular attention to both by watching our diet, exercising and making sure we sleep as best as possible. Going outside (on our own if necessary) and connecting with others (using technology if required) can be especially helpful, insofar as they are possible.
First, try your best to keep some kind of exercise regime going, no matter what. The best time to exercise is in the morning. Each week, adults should get 150 minutes of moderate aerobic activity (e.g. brisk walking or mowing the lawn) or 75 minutes of vigorous aerobic activity (e.g. running). We should also do strength exercises on two or more days, working all of our major muscles (legs, hips, back, abdomen, chest, shoulders and arms). If your favourite gym is not accessible, go outdoors if possible.
Often, just going outside is the best way to interrupt negative thought-spirals and become immersed in the world immediately around you. It is not always possible to ‘think your way’ out of anxiety. Sometimes, we need to stand up, close the laptop, leave the phone behind and just go outside.
Second, take some time to ensure that you get enough sleep. Adults ideally should have seven to nine hours sleep in every 24 hours. New-borns need 14 to 17 hours sleep; pre-schoolers need 10 to 13 hours; school-aged children need nine to 11 hours; and teenagers need eight to 10 hours. Very few of us meet these requirements. There are many ways to optimise our sleep habits and prioritising these is especially important at times of heightened anxiety or stress.
Bedrooms should be dark, cool (around 16-18° C), quiet, uncluttered and free of gadgets (such as televisions and phones). The bed should be comfortable, with a new mattress every eight to ten years. In the evening, reduce the intensity of light (using dimmer switches or low wattage bulbs); establish a bedtime routine and regular sleep pattern; avoid alcohol and sugar; try not to nap during the day; and do not use computers, mobile phones or televisions before trying to sleep.
Breathing exercises or counting sheep can help you to fall asleep. If you wake at night, follow the ‘20-minute rule’: if you cannot sleep for 20 minutes, read a (printed) book for 20 minutes and then try to sleep. If that does not work, repeat the procedure until you eventually fall asleep. Avoid alcohol, tea, coffee and screens if you are awake at night.
In addition to paying attention to diet, exercise and sleep, it is also important that coronavirus does not overshadow any other health problems that you may have or may develop. Be sure to contact your general practitioner if you have any physical illnesses or feel you are developing a mental illness, such as depression. Maintaining general health is vital during an outbreak such as the present one.
Finally, one of the best ways to maintain mental health is to find an activity that absorbs you and clears all other worries from your mind for a period of time. For many people, running provides this kind of complete absorption in the present moment. They simply lose themselves in the activity. This can also occur with jigsaws, puzzles, card games, reading, music, playing with children or spending time with a pet. For others, yoga or meditation can meet this need, and both activities can be practised alone (if self-isolating), in virtual groups (using technology) or within small groups of friends, depending on your circumstances. Whatever way you achieve it, try to spend time in a state of absorption or a state of ‘flow’ while you do some activity that you enjoy and that makes the rest of the world melt away. This refreshes your mental state and leaves you better placed to face any challenges that lie ahead.
Do reward yourself for your achievements and consciously practice compassion for yourself and others
During a pandemic, it is easy to become despondent. However, while we must acknowledge the realities of loss and bereavement, we must also find a way to carry on. Many of us have other people who rely on us: children, family members with disabilities, neighbours with illnesses and so forth. Balancing sadness with hope is difficult. The best approach is to acknowledge the broader realities of our situation but not be paralysed by them in our own lives. Focus on daily activities and short terms plans.
Above all, be compassionate towards yourself and others. Everyone is worried and each person expresses this differently. Some people express anxiety though extreme irritation and unpleasantness. Tolerating this can be difficult, but it is a good exercise in compassion if we try to understand that the other person feels the same as we do, deep down.
We should also be compassionate towards ourselves. Reward yourself for getting through the day, for exercising, for helping others, for trying to balance all of your concerns and for simply keeping going. Some days, that alone is a considerable task and it deserves recognition.
Brendan Kelly is Professor of Psychiatry at Trinity College Dublin and author of “Coping with Coronavirus. How to Stay Calm and Protect your Mental Health: A Psychological Toolkit” (Merrion Press). The e-book costs €1 and royalties will go to charities assisting with the global response to coronavirus.